Which option best matches the recommended action for a patient with an infected toenail?

• A. Start self-treatment with home antifungals
• B. Ask him to return if symptoms worsen
• C. Schedule a routine check in a week
• D. Refer him to his GP

Answer: (D)

Infected nails demand professional assessment rather than self-treatment. When the skin around a nail is red, swollen, painful, or pus is present, it’s more than a simple fungal issue and may be a bacterial infection (paronychia) or a complicated fungal infection. Over-the-counter antifungals won’t reliably treat a true infection with inflammation or pus, and delaying proper care can allow the infection to worsen or spread.

A GP can determine the cause, check for complications like cellulitis, decide if antibiotics are needed, and manage any risk factors such as diabetes or poor circulation. They can also provide appropriate treatment, including drainage if required, and guide future nail care or referrals (e.g., to podiatry) if ongoing nail problems persist. Scheduling a routine check in a week or trying self-treatment misses the opportunity to treat the infection effectively from the outset.

Seek urgent care if the redness spreads, the area becomes very warm, fever develops, or there is increasing pain or swelling, as these can indicate a more serious infection.